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Medicolegal investigation of death is the most crucial and significant function of the medical examiner within the criminal justice system. The medical examiner is primarily concerned with violent, sudden, unexpected, and suspicious deaths and is responsible for determining the cause and manner of death, identifying the deceased, determining the approximate time of death and injury, collecting evidence from the body, issuing the death certificate, and documenting these events through an official autopsy report. The basis of the medicolegal investigation is forensic pathology.Written for both medical and investigative professionals, Forensic Pathology, Second Edition presents an overview of medicolegal investigative systems. Completely updated, the book examines investigative techniques and procedures that lead to obtaining accurate conclusions of death by homicide, accident, or suicide.

Medicolegal Investigative Systems

Definition of Death

1

(1)

Delayed Deaths

2

(1)

Cause, Manner, and Mechanism of Death

3

(3)

Sudden, Unexpected Natural Death

6

(3)

The Coroner System

9

(2)

The Medical Examiner System

11

(3)

Operation of a Medical Examiner System

14

(5)

Name Accreditation

19

(1)

References

19

(2)

Time of Death

Livor Mortis

21

(5)

Rigor Mortis

26

(2)

Body Temperature

28

(2)

Decomposition

30

(5)

Chemical Changes in Body Fluids

35

(2)

Flow-Cytometry

37

(1)

Gastric Emptying and Digestion

37

(2)

Insect Activity

39

(1)

Scene Markers

40

(1)

References

41

(2)

Deaths Due to Natural Disease

Cardiovascular Disease

43

(1)

Coronary Atherosclerosis

44

(1)

Bridging

45

(1)

Dissecting Coronary Aneurysm

46

(1)

Coronary Artery Spasm

46

(1)

Mechanism of Sudden Death

47

(1)

Sudden Death: Exercise and Climate

48

(1)

Hypertensive Cardiovascular Disease

48

(1)

Cardiomyopathy

49

(3)

Valvular Disease

52

(3)

Coronary Artery Anomalies

55

(1)

Myocarditis

55

(2)

Aortic Dissection

57

(1)

Sudden Death on a Physiological Basis

58

(1)

Deaths Due to Intracranial Lesions

58

(1)

Epilepsy

58

(3)

Nontraumatic Subarachnoid Hemorrhage

61

(1)

Berry Aneurysms

61

(4)

Intracerebral Hemorrhage

65

(3)

Primary Brain Tumors

68

(1)

Meningitis

69

(2)

Reyes Syndrome

71

(1)

Hydrocephalus

72

(1)

Psychiatric Patients

73

(1)

Respiratory System

74

(1)

Epiglottitis

74

(1)

Pulmonary Thromboemboli

75

(1)

Asthma

76

(1)

Pneumonia

77

(1)

Hemoptysis

78

(1)

Spontaneous Pneumothorax of Newborns

78

(1)

Urogenital and Gastrointestinal Tracts

79

(1)

Spleen

79

(1)

Pancreas

79

(2)

Liver

81

(1)

Adrenals

82

(1)

Miscellaneous

83

(1)

Tumor and Trauma

83

(1)

References

84

(8)

Blunt Trauma Wounds

Abrasions

92

(2)

Dating of Abrasions

94

(4)

Contusions

98

(2)

Dating of Contusions

100

(2)

Postmortem Bruising

102

(1)

The Eyes and Eyelids

103

(1)

Decomposed Bodies

104

(1)

Lacerations

104

(4)

Defense Wounds Due to Blunt Force

108

(1)

Determination of Whether a Wound is Ante- or Postmortem

108

(1)

Fractures of the Face

109

(1)

Fractures of the the Extremities

110

(1)

Fractures from Direct Application of Force

111

(1)

Fractures Caused by Indirect Application of Force

112

(2)

Pelvic Fractures

114

(1)

Healing of Fractures

115

(1)

References

116

(1)

Blunt Trauma Injuries of the Trunk and Extremities

Blunt Force Injuries of the Chest

117

(1)

Injury to the Ribs

117

(1)

The Sternum

118

(1)

The Heart

119

(3)

The Aorta

122

(4)

Diaphragm

126

(1)

Lungs

126

(4)

Blunt Force Injuries of the Abdominal Viscera

130

(2)

Liver

132

(2)

Pancreas

134

(1)

Spleen

135

(1)

Gastrointestinal Tract

136

(3)

Kidneys

139

(1)

Urinary Bladder

139

(1)

Internal Genitalia

140

(1)

Blunt Force Injuries of the Estremities

140

(3)

References

143

(4)

Trauma to the Skull and Brain: Craniocerebral Injuries

Impact Injuries

147

(1)

Soft Tissue Injuries

147

(1)

Fractures of the Skull

148

(7)

Contusions of the Brain

155

(5)

Lacerating, Penetrating, and Perforating Wounds of the Brain

160

(2)

Epidural Hemorrhages

162

(3)

Acceleration/Deceleration Injuries

165

(1)

Subdural Hematomas

166

(3)

Diffuse Axonal Injury

169

(3)

Death Due to Cerebral Concussion

172

(1)

Subarachnoid Hemorrhage

173

(2)

Vertebral Artery Injury (Laceration)

175

(1)

Traumatic Injury of the Carotid Artery

176

(1)

Traumatic Dissection of Intracranial Arteries

176

(1)

Traumatic Brain Swelling and Edema

177

(2)

Boxing Injuries

179

(1)

Occipito-Cervical Injuries

180

(1)

Lacerations of the Brainstem

181

(1)

Traumatic Intracranial Aneurysms

181

(1)

Cerebral Palsy

182

(1)

References

183

(4)

Wounds Caused by Pointed and Sharp-Edged Weapons

Stab Wounds

187

(1)

Depth of Stab Wounds

188

(1)

Appearance of Stab Wounds in Skin

189

(5)

Stab Wounds from Weapons Other than Knives

194

(7)

Identifying the Weapon

201

(3)

Manner of Death

204

(2)

Stab Wounds by Anatomical Location

206

(2)

Incised-Stab Wounds

208

(1)

Physical Activity Following a Fatal Stab Wound

209

(2)

Force Necessary to Inflict Fatal Stab Wounds

211

(1)

Postmortem Bleeding

212

(1)

Incised Wounds

212

(4)

Incised Wounds of the Neck

216

(5)

Miscellaneous

221

(2)

Chop Wounds

223

(4)

Therapeutic or Diagnostic Wounds

227

(1)

References

228

(2)

Asphyxia

Suffocation

230

(1)

Entrapment / Environmental Suffocation

230

(1)

Smothering

231

(4)

Choking

235

(5)

Mechanical Asphyxia

240

(4)

Suffocating Gases

244

(1)

Strangulation

245

(12)

Ligature Strangulation

257

(5)

Manual Strangulation

262

(8)

Chemical Asphyxiants

270

(2)

Sexual Asphyxia (Autoerotic Asphyxia, Autoerotic Deaths)

272

(3)

References

275

(4)

Deaths Caused by Motor Vehicle Accidents

Causes of Motor Vehicle Accidents

279

(1)

Natural Disease as a Cause of Motor Vehicle Accidents

280

(1)

Categories of Motor Vehicle Accidents

281

(1)

Front Impact Crashes

281

(9)

Side Impact Crashes

290

(3)

Rollovers

293

(3)

Rear Impact Crashes

296

(1)

Seat Belts and Air Bags

296

(2)

Air Bags

298

(3)

Motor Vehicle Fires

301

(1)

Motorcycle Accidents

302

(3)

Suicide by Motor Vehicles

305

(1)

Determination of Who Was Driving

305

(1)

Motor Vehicle-Train Accidents

306

(1)

Toxicology in Motor Vehicle Accidents

306

(2)

Pedestrian Deaths

308

(1)

Relationship Between Speed at Impact and Injuries

308

(1)

Child Pedestrians

309

(1)

Adult Pedestrians

309

(8)

References

317

(2)

Airplane Crashes

Crashes Involving Light Planes

319

(1)

Crashes of Commercial Aircraft

320

(1)

Causes of Crashes

320

(1)

Crash Scene

321

(1)

Crash Patterns

321

(2)

In-Flight Fire

323

(1)

Helicopter Crashes

323

(1)

Hot-Air Balloons

323

(1)

Lightning Strikes

323

(1)

References

324

(2)

Sudden Infant Death Syndrome

Incidence of SIDS

326

(1)

Presentation of Cases

326

(1)

Non-Hereditary Nature of SIDS

327

(1)

Diagnosis of SIDS

328

(1)

Etiology of SIDS

328

(1)

Investigation of the Death

329

(2)

Communication with the Parents

331

(1)

References

332

(4)

Neonaticide, Infanticide, and Child Homicide

Neonaticide

336

(1)

Infanticide and Child Murder

337

(2)

Battered Baby Syndrome

339

(7)

The ``Impulse'' or ``Angry'' Homicide

346

(3)

``Gentle'' Homicides and the Lethal Variant of Munchausen's Syndrome by Proxy